Cystic adenomatoid malformation volume ratio predicts outcome in prenatally diagnosed cystic adenomatoid malformation of the lung

Crombleholme, Timothy M.; Coleman, Beverly G.; Hedrick, Holly L.; Liechty, Kenneth W.; Howell, Lori J.; Flake, Alan W.; Johnson, Mark P.; Adzick, N. Scott

doi:10.1053/jpsu.2002.30832

Cited by 451 publications

(363 citation statements)

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“…1 The large volume of these malformations may lead to fetal pulmonary and mediastinal compression, with implications for fetal prognosis. 2 At birth, most children with CPM are asymptomatic, but some develop respiratory distress that may be sufficiently severe to require mechanical ventilation and immediate surgery. 3 Many of the previous studies evaluating neonatal respiratory morbidity in children with CPM used crude indicators, such as mortality or the need for immediate surgery.…”

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confidence: 99%

Neonatal Outcomes of Prenatally Diagnosed Congenital Pulmonary Malformations

et al. 2014

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BACKGROUND AND OBJECTIVE: Congenital pulmonary malformations (CPM) are mostly recognized on prenatal ultrasound scans. In a minority of cases, they may impair breathing at birth. The factors predictive of neonatal respiratory distress are not well defined, but an understanding of these factors is essential for decisions concerning the need for the delivery to take place in a tertiary care center. The aim of this study was to identify potential predictors of respiratory distress in neonates with CPM. METHODS: We selected cases of prenatal diagnosis of hyperechoic and/or cystic lung lesions from RespiRare, the French prospective multicenter registry for liveborn children with rare respiratory diseases (2008–2013). Prenatal parameters were correlated with neonatal respiratory outcome. RESULTS: Data were analyzed for 89 children, 22 (25%) of whom had abnormal breathing at birth. Severe respiratory distress, requiring oxygen supplementation or ventilatory support, was observed in 12 neonates (13%). Respiratory distress at birth was significantly associated with the following prenatal parameters: mediastinal shift (P = .0003), polyhydramnios (P = .05), ascites (P = .0005), maximum prenatal malformation area (P = .001), and maximum congenital pulmonary malformation volume ratio (CVR) (P = .001). Severe respiratory distress, requiring oxygen at birth, was best predicted by polyhydramnios, ascites, or a CVR >0.84. CONCLUSIONS: CVR >0.84, polyhydramnios, and ascites increased the risk of respiratory complications at birth in fetuses with CPM, and especially of severe respiratory distress, requiring oxygen supplementation or more intensive intervention. In such situations, the delivery should take place in a tertiary care center.

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Neonatal Outcomes of Prenatally Diagnosed Congenital Pulmonary Malformations

et al. 2014

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“…A CVR is >1.6, the risk for hydrops ranges between 15-75%. 9 Proposed antenatal and perinatal interventions include steroid administration, intrauterine puncture or shunting of macrocytic masses, alcohol embolization or lasering of the feeding vessel or lobectomy. The evidence for these interventions is currently poor.…”

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confidence: 99%

Congenital cystic adenomatoid malformation (CCAM): antenatal and postnatal management

Kanavi

Thangaraj

Thomas

2017

Int J Reprod Contracept Obstet Gynecol

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Background: Congenital cystic adenomatoid malformation (CCAM) is a rare abnormality of lung development. The estimated incidence ranges from 1: 10,000 to 1.35,000 live births. It is diagnosed by prenatal screening at 18-20 weeks of gestation. Surgical excision of symptomatic lesions is relatively straight forward, but management of asymptomatic lesions is controversial. Methods: Among women who delivered at St. Johns medical college and hospital, Bangalore between Jan 2011 to Dec 2016, those with the diagnosis of CCAM during anomaly scan were included in the study. Antenatal and Postnatal period and their outcomes were evaluated. Follow up was extend up to the childhood in the affected foetus. Results: There were 5 cases of CCAM in 13057 deliveries during 5-year study. Incidence was 1:2611. Mean gestational age at diagnosis was 21.6±2.5weeks. All foetus had CVR (CCAM volume) ratio more than 1.6 and there was no compromise on lung volume. Mean lung volume was 62.8±8.6 cc. and mean Apgar score at 1minute was 6.8±2.7 and at 5 minutes was 8.0±2.2. Among 5 foetuses, 2 foetuses had regression of cyst by birth and 3 underwent surgery for resection after birth. Conclusions: CCAM remains a challenge for obstetricians, neonatologists and paediatric surgeons. The combination of prenatal MRI and serial ultrasound studies optimize foetal surveillance and postnatal care. In asymptomatic CCAM, babies should be followed up to adolescence and adulthood, as they can manifest with malignant changes.

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“…21,22 Kistik havayolu hastalıkları, bu grup içinde 10.000'de 0,66 sıklık ile en sık görülen tiptir. Sık-lıkla akciğerlerin gelişiminin bir safhasında durması ve terminal bronşiyollerin düzensiz olarak çoğalması sonucu meydana gelmektedir.…”

Section: Konjeni̇tal Bronkopulmoner Malformasyonlarunclassified

Current Approach for Prenatally Diagnosed Congenital Anomalies That Requires Surgery

Aydın¹

2017

Turkiye Klinikleri J Gynecol Obst

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ünümüzde gelişen teknoloji ve farkındalık ile birlikte doğumsal anomaliler sıklıkla prenatal dönemde tanı almaktadır. Ülkemizde bu hastalar ile ilk karşılaşanlar kadın-doğum uzmanlarıdır. Özellikle de eğitim ve araştırma hastaneleri ile üniversite hastaneleri dışında çalışan kadın-doğum uzmanlarının hangi hastalığın prenatal veya postnatal müda-hale gerektirebileceği konusunda bilgi sahibi olmaları önemlidir. Böylelikle hem doğum yöntemini doğru tayin edebilirler hem de hastaları doğru merkezlere yönlendirebilirler. Herhangi bir doğumsal anomaliye ilk tanı konulduğunda ailelerin önünde birden fazla seçenek bulunmaktadır. Bunlar sezaryen ile veya normal spontan doğum, ultrasonografi (USG) eşliğinde müdahale, fetoskopik müdahale, açık fetal cerrahi, ekstrauterin intraparTurkiye Klinikleri J Gynecol Obst 2017;27(4):193-9 193 Prenatal Tanılı Cerrahi Gerektiren Doğumsal Problemlere Mevcut Yaklaşım Ö ÖZ ZE ET T Bu çalışma ile mevcut literatür bilgileri ışığında prenatal cerrahi gerektiren bazı doğumsal problemlere yaklaşımı ortaya koymayı ve ülkemizde bu konuya dikkat çekmeyi amaçladık. Karın duvarı defektleri, doğumsal diyafram hernisi, havayolu kitleleri, hidrops fetalis ve ikizden ikize kan transfüzyonu sendromuna yönelik yapılmış olan ve PubMed'de bulunan prenatal tanı yöntemleri incelendi. Yukarıda yer alan hastalıklara yönelik literatürde yer alan en son çalışmalar irdelendi. Hastalıkların sıklığı, tanı yöntemi, hastalara yaklaşım, eşlik eden hastalıklar, prenatal ve postnatal müdahaleler değerlendirildi. Özellikle kadın-doğum uzmanları gebelik izlemleri sırasında prenatal dönemde müdahale gerektirebilecek doğumsal anomaliler ile karşılaşmaktadırlar. Bu olguların ileri tetkiklerinin yapılabileceği ve müdahalede bulunabileceği bir merkeze yönlendirilmeleri hem anne hem de bebek açısından zaruridir.A An na ah h t ta ar r K Ke e l li i m me e l le er r: : Fetal tedaviler; prenatal tanı; fetal mortalite; fetal hastalıklar; fetofetal transfüzyon; hidrops fetalis A AB BS S T TR RA AC CT T Our aim is to demonstrate the current management of some of congenital anomalies those may need prenatal surgical correction and to arouse awareness of them. Studies related with prenatal diagnosis and management of abdominal wall defects, congenital diaphragmatic hernia, congenital pulmonary diseases and twin to twin transfusion syndrome in PubMed database were searched. They were analyzed according to incidence of the disease, diagnostic modalities, management of patients, comorbidities and prenatal and postnatal treatment options. Obstetricians mostly encountered with congenital anomalies that can need prenatal management. It's crucial both for the baby and mother to be referred to a center that prenatal and postnatal management can be done properly.K Ke ey yw wo or rd ds s:

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Cystic adenomatoid malformation volume ratio predicts outcome in prenatally diagnosed cystic adenomatoid malformation of the lung

Cited by 451 publications

References 1 publication

Neonatal Outcomes of Prenatally Diagnosed Congenital Pulmonary Malformations

Neonatal Outcomes of Prenatally Diagnosed Congenital Pulmonary Malformations

Congenital cystic adenomatoid malformation (CCAM): antenatal and postnatal management

Current Approach for Prenatally Diagnosed Congenital Anomalies That Requires Surgery

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